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Home My WebLink AboutX2022-1541 - PermitsCity of Newport Beach -Building Division COMB Permit: X2022-1541 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 2 2 1 5 4 1 Project No: 1317-2021 E~ '. Permit Counter Phone (949)644-3288 u Inspection Requests Phone (949)644-3255 1d. Issued Date : 05/31/2022 Combination Type - SFP Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID Construction Hours: Monday- Friday 7:00 a.m, to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 9 CAPE WOODBURY NB Description: SFR REROOF T/O COMP SHINGLES AND REPLACE WI COMP 32 SOS Legal Desc.: N TR 15012 LOT 71 , Owner: BETETA CINDY Address: 9 CAPE WOODBURY NEWPORT BEACH, CA 92660 Phone: 562-434-6993 Applicant: GREEN SHIELD ROOFING Address: 4120 W 136TH ST#A HAWTHORNE CA 90250 Phone: 310-462-1872 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $351.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $352.00 PROCESSED BY: ZONING APPROVAL: Contractor: GREEN SHIELD ROOFING Address: 4120 W 136TH ST#A HAWTHORNE CA 90260 Phone: 310-462-1872 Con State Lic: 1079372 Lic Expire: 0813112023 Bus Lic: BT30078245 Lic Exp Date: 03131/2023 Worker's Compensation Insurance Carrier: STATE COMP. INS Policy No: 9302037 Expire: 07/1612022 Building Setbacks Use Zone: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical W Plumbing %: Rear: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee: Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $0.00 ING"TECR State Lic: Fire Department $0.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fee Due at Permit Issuance : $352.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of prooerty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I amexempt from licensure under the Contractors' State License Law for the following reason: By my signature beow I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure teat Irave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Frof_�ssiLns Code, Is available upon request when this application is submitted or at the following Web site:http://www.leginfo,ca.gov/calaw.html. Signature of Pra9erty Owner or Authorized Agent Date L ICSNSED CON i RACTOR'S DECLARATION I nereoy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) of Division 3 of the Business and Pro lions de, id m li ense is in full force anJ el-f�ct. LIG6r.3d Clcss License No Dat f_Contractor Signatur WORKERS' COMPENSATION DECLARATION ✓+Aft NIHl ; FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO rD DOLLARS ($100,000), IN ADDITION TO THE COST OF IOMPENS4TION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I ",ebyaffirm under penalty of perjury one of the following declarations: dove and will winotain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th, performance of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' race carrier and policy number are: Policy Number of Agent Date I certify that, in the perfo mane. of th k for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre d, if I should become su ject to the orker sation ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. P (' ]nature of Applicant DatX t n � I ///i� :CLARATION REGARDING COX9TRUCTIONLIENDING AGENCY ereby affirm under penalty of p 'ury that the is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). nder's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and cou ty ordinan late laws relating to building construction. I authorize representatives of this city or count enter th abov denti eoperty for inspection purposes. / 1 N rem _w In —.I AIr 2: _ 9 Owner or Authorized ACTION I DATE I BY PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED EPA Print Property Owner's or Authorized A PLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 61 OF TITLE 40 AND A( RULE NOTIFICATION TO APPLICABLE TO